Read Provider Update

This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.

  • P = Professional
  • B = Behavioral health
  • F = Facilities

A Word from Dr. Collins

P B F
1 Jun, 2021
The primary care structure in the U.S. is in the midst of a very important overhaul. For too long, p...
P B F
1 de maio, 2021
In 20 de junho18, we held our first Medical Expense Trend (MET) Summit, where we invited our provider co...
P B F
1 Mar, 2021
Of course, the COVID-19 vaccine is THE topic of the moment. And as the state’s largest health insure...

BCBSRI Update

P F
7 Jun, 2021
BCBSRI will resume prior authorization for all products effective 11 de junho, 2021 with the exception i...
P F
1 Jun, 2021
When adding a Servicing and/or Facility provider to a prior authorization request in MHK, please pay...
P B F
1 Jun, 2021
As a reminder when sending medical records to BCBSRI, a valid cover sheet should be placed on top an...

Provider Relations

P B F
1 Jun, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...
P B F
1 de maio, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...
P B F
1 Abr, 2021
As a BCBSRI-contracted provider, it is your obligation to coordinate member care with contracted, in...

Physician & Provider Call Center

P B F
1 Jun, 2021
  Did you know our secured Physician and Provider Portal offers the following: •Check member benef...

Quality

1 Jun, 2021
PRENATAL & POSTPARTUM CARE (PPC) Eligible population: Delivered a live birth on or between Octo...
P
1 de maio, 2021
BCBSRI is committed to making it easier for your practice to be successful in all areas of quality i...
P
1 Abr, 2021
As a reminder, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey was sent t...

Behavioral Health

B
1 de maio, 2021
The Dementia Care Coordination Program is a referral-based program based on a Veterans Administratio...
P B F
1 Abr, 2021
April is National Alcohol Awareness Month. Founded and sponsored by the National Council on Alcohol ...
P B
12 Nov, 2020
Program overview: The Dementia Care Coordination Program is an evidence-informed intervention based ...

Farmácia

P F
1 Jun, 2021
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P B F
1 Abr, 2021
The information below is effective as of 1 de abril, 2021 and applies to all commercial BCBSRI products...
P F
1 Abr, 2021
The following Commercial MDR drugs will require step therapy through a biosimilar effective 4/1/21: ...

Products & Benefits

P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...

Reivindicações

P B F
1 Jun, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...
P B F
1 de maio, 2021
As a reminder, when filing a claim for an unlisted procedure code, please include the Unlisted Proce...
P B F
1 Abr, 2021
As a reminder when sending in Medical Records to BCBSRI, a valid coversheet should be placed on top ...

Policies

P F
1 Jun, 2021
We have completed our review of the 20 de junho21 CPT code changes, including any Category II performanc...
P F
1 Jun, 2021
The following policies were recently reviewed for annual update. The full texts of these policies ar...
P B F
1 Jun, 2021
BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...
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